Depression and the use of diabetes as self-harm

Coping & Support
1

I am 26 years old and was diagnosed in October. This year has been horrible for me. First, I got my T1D diagnosis. A few months later, my significant other of 5 years left me and forced me to move out of our house. A few weeks after that, my mother was diagnosed with pancreatic cancer. She is physically reacting poorly to the treatment (even for a cancer patient). I was also having employment problems, but they have been resolved so far.

I have come here as a place of no judgement. I never tell anyone that I do this.

Sometimes I purposely take little to no insulin (like today). Just to hurt myself. Just to feel shitty. Just to feel terrible. Just to harm every piece of my own body. Sometimes I eat carbs or sugar just to make it worse. I am still honeymooning (I know because I do this to myself) so it is not as life threatening as it is for someone who produces zero insulin. I think this may be a unqiue T1D way of wrist cutting? I still monitor my blood sugar when I do this.

I don’t know why I am writing this. Just wanted to tell somebody who will listen or maybe has a similar experience.

Thank you

2

Hi,

You are about to get the usual “I’m so sorry…” followed by suggestions for assistance. I won’t trounce on those as they may be just the ticket you need. I read between the lines and see you are also trying to still maintain control and you have a need to reach out. Watch the cause and effects of what you’re doing and reach out further if needed. You’ll be okay…

3

I’ve had T1 for 32 years now, and I’ve definitely had many of those moments. My thoughts on those days/weeks/months have ranged from “Dang it, these numbers are totally screwy and I have no idea why because I’m doing everything right, so I just give up…” to “What’s the point in checking my BG if I’m doomed to get complications anyway?” I sometimes have a good pity-party, curl up in a fetal position, and just cry my eyes out until I’m exhausted. For me, that works. It lets me get all the negativity out and I usually wake up the next morning ready to take it on again, and occasionally even refreshed. Are you seeing a counselor? Not that anyone but another T1 can totally get our day-to-day existence, but at least they are trained to help people process and manage negative feelings so they don’t consume you. I do encourage you to see someone for a “tune-up” every so often to help you manage your mental health. Our brains are not well-understood, but are arguably our most important organ to take care of.

4

You are not the first person with T1D who withholds insulin… reasons for doing it are varied - tired of it, lose weight, forget to give the insulin… the reasons are varied as the people who are struggling. I think the important part is you are reaching out for help. I think what Angivan said is spot on. You have a ton on your plate and I totally get why your focus isn’t on T1D care right now. Keep trying. Reach out to your friends to see if they can help. Keep reaching out to us here on TypeOneNation. We get it. We really do. You are not alone.

5

It sounds like you have had a lot thrown your way over the last year, so I won’t try to tell you I know exactly how you feel or throw judgement at you. All of us that are living with Type 1 Diabetes know that managing it can be overwhelming at times and we all cope in different ways. Try and hang in there and remember that by taking good care of yourself, it will help you better cope with stress and be more supportive of your Mother and others around you. You will feel better physically and mentally. If all the other things going on in your life are out of your control I would encourage you to focus on the things you do have control of. That is what will help get you through these difficult times.

My thoughts and prayers go out to you and your family!

6

I’m betting you’ll get some folks telling you stuff like “God only gives you as much as you can handle, blah, blah, blah.” I’m not knocking religion for those who embrace it, but when I’m told that, I call bullshit.

You’ve been handed a ton of crappy stuff in a short amount of time, and it sucks. Any one of those things you mentioned happening sucks, and all crammed together makes them even worse. First of all, I’m sorry you’ve joined our team, and I’m really sorry about your mom. I lost my mom 8 years ago to a terrible cancer. I was her primary caregiver so my control during that year and a half wasn’t great. My A1C went up, and I gained weight from self medicating with some lousy food choices while feeling sorry for me, and for her.

Ultimately, you’re right; diabetes is about control. Plus, you’re young :slight_smile: When I was in my mid-20s I was partying pretty heavily and if I’d also had diabetes, I can’t imagine how I would’ve handled it.

What I can say now, as a 55-year old, is that life is so damn short already, that we need to do anything and everything we can to get as many quality years here as we can! I didn’t think much about my mortality or old age when I was your age, but now it freaks me out a little.

I’m really tightly managed these days, and have been since I was pregnant with my first son, who’ll be 24 next month. I didn’t really want kids, so when I found myself pregnant, I knew I had to be in good control for my child. After that, it became about wanting to be here to take care of him and see him grow up. Of course, as soon as he was born, I fell head over heels in love, and was thrilled to have another son a few years later.

My mom’s illness was really my first time dealing with a terminal disease. Her cancer made me realize how lucky I am: if I have to have a disease, at least I have one that responds to my efforts! It sounds like you know about diabetes; becoming super educated about it has helped me in many ways.

That also means you know that your choices could be leading to harmful complications that suck worse that limiting carbs or using insulin. I’m a full-time artist and instructor; if I lost my vision, I don’t know what my life would look like!

In many ways you’re lucky you’ve been diagnosed now. Insulin pumps, CGMS, and the internet have made such a tremendous difference in the care we receive and the networking we can participate in! An anonymous forum like this, and reaching out like you’ve done, may be just the outlet you need to share your feelings rather than do hurtful things regarding your health.

I don’t believe there’s anything wrong in feeling sorry for yourself now and then, and for sure I eat unnecessary carbs now and then, but I also bolus to keep my blood sugar as close to normal as possible. :slight_smile:

Hang in there; and keep posting. I hope your mom’s treatment improves.

Valerie

7

Sir Rupert, I am so sorry u are bottoming out right now. We have all been there at some point in our lives, you are just strong enough to admit it. Kudos to you for reaching out and not hiding in your closet like I have done in the past. Sometimes life does throw more at you than you can handle on your own. Sometimes it is just not fair and it is just right to be pissed and angry. I tend to abuse myself out of frustration too. My son has type 1, not me. That is what pisses me off the most. He was a beautiful, healthy baby boy that I waited years for and at 16 months old he was diagnosed. I have begged and prayed for God to take it from him and give it to me. I deserve to be sick, he does not. We have had some hard years. He is 10 now and doing sooooo much better. I was so overwhelmed back when he was diagnosed that I just wanted to give up. And to be honest, I did some dumb things out of anger. It has taken me a long time to forgive myself for being so angry in the past. You see, life is soooooo much better right now. I would have bet everything in this world that it would not be like it is now, back then. You just have to push forward through this hard time. It will pay off later, you just have to have some faith in that (hopefully, more than I did). You are young and have so much going for you! Take one day at a time with your Mom. At least you get some more days or even years with her. I lost my Dad when I was 19 to a massive heart attack. I watched the life slip from his body in my arms on our living room floor. I was officially a grown up after that night. I found myself very alone after losing him. Then a year later, I found myself fighting for my own life after being hit head on by a drunk driver. You see, everyone has horrible life stories and we survive them and move forward. I used to hate all my scars until the day I found the courage to show them to my fiancé and he told me how beautiful they were because they were “scars of courage”. You too, will have these “scars of courage” as you go through bad times like you are right now. I wish I could wrap my arms around you and hold you and tell you that all will be better soon. Because it will. It may be a rough road before it gets better but you are a survivor! Put on some of your favorite music, turn it up LOUD! Watch the sunset tonight. Just find some peace and comfort around you in any way you can. Hang in there my friend, good things are out there for you!

8

Sir_Rupert, You don’t need to hurt yourself since none of what is on your plate right now are you responsible for! None of it! NONE!!! (And hurting yourself won’t fix your mother, your lost companion, or your diabetes at all. Believe me–it’s not fair, but you CAN make it through it all–with a little help from your friends!

My suggestions may sound a little weird to everyone here, but I will say it anyway. You need to forget about your diabetes for a minute and cope with the other stuff.

First let me say that many of us with T1D have used insulin and diet as tools to cope with overwhelm and depression. So please do NOT beat yourself up for doing that. It’s alright that you used the only coping skill you could think of. It’s not a healthy one however, so we need to help you as a community to find a coping skill that is healthy, you can do without much thought. Here are some of the tools I use when I become overwhelmed:

  1. I set alarms on my phone for when I am supposed to eat and check blood glucose. Overwhelm tends to clear my brain of any need for food. lol This takes one thing I have to remember to do off my plate.
  2. I celebrate my achievements—congratulate yourself on having resolved the employment issue already! That takes two things off the plate.
  3. Find a support site or group (and in this case I would suggest an actual in-person group) who deal with families of cancer patients. You need to have somewhere that you can dump your fears and concerns about your mother’s diagnosis AND how treatment is not working well for her. You will find many people who are going through the same problems, maybe a different family member or type of cancer, but some of them will have already found resources and coping skills and can share them with you. This doesn’t take this issue of your plate, but it will ease a bit of the stress of dealing with it. Ask your Mother’s oncologist. He should have a list of groups available in your area.
  4. I am not a big supporter of putting ANYTHING on the back burner for coping later, but I think it might be wise to put “living with a recent break-up of a long-term relationship” until you can get new coping skills created and mastered to the point of being habitual.

Living with T1D will never leave your plate, so you need to learn how to make as much of its requirements habitual as possible. Then check, assess, change, check, assess, change… The habits will get the food eaten, the blood sugar checked at the right time, and the insulin taken on time. I have had T1D for 32.5 years now and I STILL have my meal and bg times set on my phone. I still meet with groups for support in dealing with the ups and downs of chronic disease. I still look for new information and learn new methods from tons of resources. And I still get stressed out and say, “I quit!!!” But with a monthly or weekly or daily (whatever time frame fits the current level on my plate) re-arranging of the plate and throwing away of unnecessary demands, I seldom “quit” for more than a day before I feel more positive again and can go ahead with my newly structured plan of action.

You can’t clear your plate right now, so make as much of it automatic and/or supported as possible and you will do fine.

9

Just wanted to let you know that I have been where you are in regards to omitting insulin. The reasons you gave about why you do it are pretty much the same reasons I had.

I’m 41 and have had Type 1 Diabetes since I was 16.

Just wanted you to know that someone else understands…me.

10

Clearly you have been through a lot, but that you know what your doing, I think it’s a good sign.
I’m also 26, I was diagnosed a long time ago and also not winning the lottery of life right now, and I did the same thing as you. Sometimes I still do when life becomes so overwhelming and I don’t know how to cope anymore. Sometimes it’s because I know when it’s high, for a little while I don’t have to think about it, don’t have to count and calculate it will stay that way. Sometimes I did just out of self harm really.
You do what you have to do so you can deal with your life, but in the meantime you can’t give up on yourself, you have to search for better solutions, for help that you can accept and it may be surprising but people can be very helpful :slight_smile:
I’m not saying everything will be sunny and happy all of a sudden, everybody has bad days (or month or year) and there are days when you will still feel broken and you would say I’m too beat down to even get out of bed, but you have to somehow take care of yourself and hope that tomorrow will be better.
Thanks for sharing this by the way and wishing you strength and a sense of humor, because you will need it!

11

I heard once that diabetes burnout is when you look at the number on the meter and you just don’t care. I know that feeling well, and that “burnout” can be a pretty wide spectrum - from feeling just a little annoyed and bummed out to full-blown “f*& it" syndrome where all hope is gone and negative, self-destructive thoughts and tendencies reign. For me (30 years old, diagnosed 3 years ago) I kind of bargain with myself - I know that those bad, self-loathing, binge eating "f*& it” times will happen, so when I’m NOT there, and I’m feeling even a little bit empowered, I grab on and hold on for dear life. If I “allow” myself the bad days (and they can be really bad, sounding a lot like yours) then I sort of get myself back on the horse that much sooner. Because nothing prolongs self-hatred like beating yourself up. So if I can offer any advice, and what worked for me is being gentle with myself during those bad days. They haven’t stopped happening, but they do seem to be a lot fewer and further between. Good luck and way to reach out for help - that’s half the battle!

12

Depression IS a complication of diabetes, also around your age my thyroid gland stopped working. Blood test and competent endocrinologist can help you out. I have had T1 for a very long time, mostly when I would ALLOW them to run A1c’s they would be 8 & 9. After years of feeling like “I’m not good enough” and shameful about NOT managing my diabetes their way I told “them” i do the best I can. No matter what I take my insulin, because I don’t want to go to a hospital for care. Try and find a psychiatrist or therapist that has experience working with people living with a chronic disease for support and guidance. I am very sorry about your recent loses, losing your Mom is really a big deal. I am sorry you don’t have anyone that can be gentle to you. You’ll have to do it yourself for now until you develop a support family. Just take some insulin daily good luck to you.

13

Thank you guys. It helped so much to hear from others about this. I cried reading these. The past couple of days I have taken care of myself, but I think that may have to do with upcoming doctor’s appointments. I fear that after they are over, I will not take insulin again. However, right now I feel sooo much better! I don’t feel like my head is in a sugar daze. I will have to remember that this is what it’s like to feel good.

14

Oh, the sugar daze. I unexpectedly went low very quickly last night, about 52, not sure why because I didn’t eat or do anything unusual. It took me a hour to come back up. As a result, I ate more than normal to get myself back up, and we all know what that means. Mr. Liver kicked in some sugar and of course I shot up to the high 200’s in the middle of the night, and it took me hours to come back down. The “hypo hangover”. The rollercoaster stuff is what makes me crazy more than anything. It’s like walking a delicate tightrope trying to hit that perfect BG window, and when you fall off, it’s bad.

15

@jholiver3, just a pause to say that it’s an interesting perspective.

@Sir_Rupert, you already know what you are doing to yourself. it was the year that I quit smoking, separated from my wife due to addiction and infidelity, sold my house out of necessity and became bankrupt, and oh yes - my dog died; that turned out to be the most formative and important time in my entire life. you know all about your past, it’s what you do right now that will make a difference, or not.

16

Sir Rupert - I appreciate your honesty and want to thank you for sharing your experience and fears. It motivated me to post for the first time.

Today I turned 55 and was diagnosed T1 in February 2015. I’ve been trying to read as much as I can find about this disease and find the feedback on this site very helpful.

I recently learned how stress impacts my BG. I was both frustrated and surprised with the quick changes in test results (both up and down) for seemingly no reason. My employer announced layoffs and for the 2 months between the announcement and the day I was told I still had a job, my BG seemed out of my control (even while eating, exercising and taking insulin as I had before). Within a hour of hearing my job was safe, my BG dropped back to normal ranges. But I felt pretty helpless during that time and, at times thought “why bother”.

Thanks. Stay strong and vigilant in taking care of you right now.

17

Thank you for sharing this. As a parent of a teen with T1, I’ve struggled in helping him sort through this. It’s good to know that we are not alone.

18

As others have said, there are many reasons why someone with T1D may omit their insulin, but all tend to be some kind of coping mechanism revolving around “control” or lack thereof. You may find it interesting there is a term coined for this, called “diabulemia.” This term refers specifically to the concept of omitting insulin in order to lose or control weight, but it is an interesting comparison. Eating disorders are all about control or lack there of, too. And there are helpful comparisons in terms of coping. I recommend this book:

Remember, you are not alone in your diabetes coping and management. Many of us have come before you and are willing to help and support.

Amy, T1D for 31 years, dx at the age of 5.

19

I have a similar situation. I use my diabetes as a way to feel crappy. I am only 15. I am so stressed out dealing with everything and then am depressed all the time, and use my diabetes as a self harming. I won’t take my sugars or insulin and eat whatever I feel like. It makes me feel crappy. But then my mom finds what I am doing and I don’t know how to explain it to her. Any advice?